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Missouri: Using a Regional Technical Assistance Infrastructure to Promote Employment First

Originally published: 8/2014


Case management services in Missouri’s Division of Developmental Disabilities underwent a shift from a state structure to a regional structure. Within this structure, 12 regions each serve approximately 12–15 counties. Each region has a technical assistance (TA) position designed to support each of the designated priority work areas. These include self-determination, family supports, individual supports and services, Employment First, and accessible housing.

When the change from a state to regional structure occurred, administrators had to look for staff who could support those priorities. In addition, they created a central technical assistance staff person to act as the state content expert in each priority area. This person provides technical assistance to the regional technical assistance providers. For example, the central Employment First TA staff person acts as an ongoing resource to all of the regional Employment First TA providers across the state.


These technical assistance positions have only been defined in the last three years. During that time administrators laid out the expectations and functions in order to build the expertise and skill levels of those working in the regional offices.

At the time the priorities were developed, state administrators felt that there was a lack of staff capacity to provide adequate support in the priority work areas. As each position was defined and applicants were hired, lead staff at the central office developed resources and handbooks for each priority area/position, editing them collaboratively with each newly hired regional person. The participatory nature of this process led to shared decision making around the details and a mutual understanding of the position and the expectations thereof.

Over time, some of the priority areas, and their specific titles, have evolved to underscore certain aspects of the priority. For example, the technical assistance providers who support the Employment First priority area are now called the Youth Transition/Employment Resource Coordinators. The “Youth Transition” portion of the title was added to underscore the importance of this target population and the unique strategies for that group within the context of Employment First.

The Youth Transition/Employment Resource Coordinators, as well as the other regional TA support people, perform a number of important duties. Not only are they responsible for keeping up with their region’s activities regarding their priority area, but they must remain familiar with resources, opportunities, and other agencies with similar services and objectives. Each regional TA person works at multiple levels performing such tasks as creating interagency linkages, conducting staff training, initiating outreach to businesses and other stakeholders, and supporting individual level problem solving.


The creation of the regional technical assistance structure emphasized the importance of employment as a priority at the individual and systems level. Within the Employment First priority area, the Youth Transition/Employment Resource Coordinators have worked to build relationships with school administrators and educators, community members, and other service delivery partners, including the department of vocational rehabilitation. Having each coordinator responsible for tracking the ever-changing regional environment, including the full range of resources, has allowed a higher level of expertise.


For more information, contact:

Julia LePage
Director, Community Supports Unit
MO Department of Mental Health, Division of Developmental Disabilities
(573) 526-3848 

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